102 CLINICAL CHARACTERISTICS AND SURGICAL OUTCOMES OF PENETRATING EXTERNAL GENITAL INJURIES

Abstract

You have accessJournal of UrologyTrauma/Reconstruction: Trauma & Reconstructive Surgery II1 Apr 2012102 CLINICAL CHARACTERISTICS AND SURGICAL OUTCOMES OF PENETRATING EXTERNAL GENITAL INJURIES Marc A. Bjurlin, Dae Y. Kim, Lee C. Zhao, Cristi J. Palmer, and Courtney M.P. Hollowell Marc A. BjurlinMarc A. Bjurlin Chicago, IL More articles by this author , Dae Y. KimDae Y. Kim Chicago, IL More articles by this author , Lee C. ZhaoLee C. Zhao Chicago, IL More articles by this author , Cristi J. PalmerCristi J. Palmer Chicago, IL More articles by this author , and Courtney M.P. HollowellCourtney M.P. Hollowell 60612, IL More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.149AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Penetrating external genital injuries are uncommon, and may present complex problems for the urologic and trauma surgeon. The study objective was to investigate the etiology, operative management, and outcomes of penetrating external genital injuries. METHODS Penetrating external genital trauma presenting from 2004-2011 were reviewed. Patient characteristics, management, and outcomes were analyzed. RESULTS A total of 151 patients sustained penetrating external genital trauma. Gunshot wounds (GSW) accounted for the most common mechanism of injury (93%), followed by impalements (3%), bites (2%), and self emasculation (1%). Scrotal injuries occurred in 78% and of these injuries, 55% resulted in a testicular injury with bilateral testicular injuries occurring in 12%. Testicular repair was able to be performed in 61% and the remaining 39% requiring orchiectomy. Penile injuries occurred in 25% with 51% with concomitant urethral injuries. For penile injuries, 64% were explored immediately. Among urethral injuries, 60% required immediate surgical repair, and 40% were managed conservatively with catheter drainage. Scrotal injuries had concomitant penile injuries in 17%. In total, nonoperative management was performed in 34% of scrotal and 38% of penile injuries. In our series, the incidence of penetrating external genital injuries has remained constant over our study period, averaging 18.8 cases per year (R2=0.99). The testicular salvage rate varied from 50% to 75% per year (R2=0.06). CONCLUSIONS To our knowledge this is the largest civilian series of penetrating external genital trauma. Scrotal injury from GSW is the most common form of penetrating external genital trauma. Testicular preservation was able to be performed in over half of penetrating testicular injuries. Penile injuries were less likely to require surgical exploration than scrotal injuries, likely because physical exam is better at confirming only superficial injury. Select patients with superficial scrotal or penile injuries may undergo nonoperative management with minimal morbidity. Table 1. Characteristics of External Penetrating Genitourinary Trauma N = Frequency (%) Scrotal injury 118(78%) Associated unilateral testicular injury 65(55%) Bilateral testicular injury 9(12%) Testicular salvage/repair 41(61%) Penile injury 39(25%) Immediate surgery for penile injury 25(64%) Associated urethral injury 20(51%) Immediate surgery for urethral injury 12(60%) © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e41 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Marc A. Bjurlin Chicago, IL More articles by this author Dae Y. Kim Chicago, IL More articles by this author Lee C. Zhao Chicago, IL More articles by this author Cristi J. Palmer Chicago, IL More articles by this author Courtney M.P. Hollowell 60612, IL More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...